A patient has confirmed primary hyperparathyroidism, adjusted calcium 2.70 mmol/L, a distal-radius T-score of −2.7 and recurrent renal stones. Kidney

Question

A patient has confirmed primary hyperparathyroidism, adjusted calcium 2.70 mmol/L, a distal-radius T-score of −2.7 and recurrent renal stones. Kidney function is preserved. Which management recommendation is most appropriate?

Accepted Answer

Refer for assessment by a specialist parathyroid surgeon

Answer

Start an oral bisphosphonate as definitive disease treatment

Answer

Start a thiazide diuretic and repeat urinary calcium annually

Answer

Start cinacalcet and defer surgical assessment indefinitely

Answer

Continue annual biochemical monitoring without surgical assessment

Primary hyperparathyroidism — SCE Rheumatology MCQ

A patient has confirmed primary hyperparathyroidism, adjusted calcium 2.70 mmol/L, a distal-radius T-score of −2.7 and recurrent renal stones. Kidney function is preserved. Which management recommendation is most appropriate?